Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: KEGG:D02448 (Fansidar)
 243 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

At a time when Fansimef, the fixed combination of mefloquine, sulfadoxine and pyrimethamine was considered for prophylaxis of falciparum malaria, a randomized double-blind study comparing the efficacy and tolerability of Fansimef with that of Lariam (mefloquine), Fansidar, chloroquine and placebo in malaria prophylaxis was performed in Thailand from July 1987 to January 1988. The study population of 602 adult males was recruited in Pak Tongchai District, some 360 km North-East of Bangkok, where multiresistant P. falciparum is endemic. All active treatments and placebo were given once weekly for 24 weeks with doses as follows: Fansimef: 125 mg mefloquine + 250 mg sulfadoxine + 12.5 mg pyrimethamine (1 half-strength tablet); Lariam: 125 mg mefloquine (1 half-strength tablet); Fansidar: 500 mg sulfadoxine + 25 mg pyrimethamine; chloroquine; 300 mg. A loading dose of 2 half-strength tablets was given in the Fansimef group in weeks 1 and 2 and in the Lariam group in weeks 1 to 4. The incidence of acute episodes of P. falciparum per 100 person months of prophylaxis was 0.17 each in the Fansimef and the Lariam groups, 1.18 in the Fansidar group, 0.69 in the chloroquine group and 0.64 in the placebo group (differences statistically not significant). Clinically adverse events were reported by 170 subjects (Fansimef 28, Lariam 29, Fansidar 41, choroquine 43, placebo 29; differences statistically not significant). The most frequent adverse events in all groups were headache, sleepiness, dizziness and weakness.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fansimef for prophylaxis of malaria: a double-blind randomized placebo controlled trial. 129 89

From July 1987 to June 1988 a randomized, double-blind, comparative placebo-controlled field trial was conducted in a group of villages near Ibadan, Nigeria. The aim of the study was to assess the suppressive tolerability and efficacy of four antimalarials (Fansimef, Lariam, Fansidar, chloroquine) given for 24 weeks. Fansimef and Lariam were given with loading and maintenance doses, Fansidar and chloroquine as one tablet per week for 24 weeks. Of 567 enrolled subjects, 114 (20%) had parasitaemia on entry. Eight episodes of symptomatic falciparum malaria occurred during the trial, seven in the placebo group, and one in the Fansimef group. Compared with placebo, parasitaemia was effectively suppressed by all four drug regimens. Adverse event data were not significantly different between groups: six adverse events per 114 participants in the Fansimef group, six/113 in the mefloquine group, five/111 in the Fansidar group, 17/115 in the chloroquine group and eight/114 in the placebo group. Safety of Fansimef for 24 weeks in endemic areas was comparable for standard antimalarials in this trial and provides support for the use of this drug for the treatment of resistant malaria in indigenous African populations.
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PMID:Mefloquine-sulphadoxine-pyrimethamine (Fansimef, Roche) in the prophylaxis of Plasmodium falciparum malaria: a double-blind, comparative, placebo-controlled study. 130 98

Malaria is largely preventable, so travelers should be taught general protective measures and given appropriate chemoprophylaxis before they leave on their trip. Chloroquine phosphate (Aralen) is still the drug of choice in locations where malaria remains chloroquine-sensitive. However, chloroquine-resistant areas infested with Plasmodium falciparum are becoming more numerous. In such areas, mefloquine hydrochloride (Lariam), doxycycline, or proguanil (Paludrine) (obtainable outside the United States) may be used. A single dose of pyrimethamine-sulfadoxine (Fansidar) may be used to treat presumptive malarial infection if medical care is not immediately available. For prevention of relapse of Plasmodium vivax and Plasmodium ovale infection, primaquine phosphate is recommended for the final 2 weeks of chemoprophylaxis on return from a malarious area.
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PMID:Prophylaxis for malaria. Helping world travelers come home healthy. 151 52

Recommendations for the prevention of malaria among travelers have been developed by CDC in consultation with representatives from the Offices of Medical Services of the Department of State and the Peace Corps; the Division of Experimental Therapeutics of the Walter Reed Army Institute of Research; the Office of the Surgeon General, U.S. Army; the Office of the Surgeon General, U.S. Air Force; and the Bureau of Medicine and Surgery, U.S. Navy. Resistance of Plasmodium falciparum to chloroquine has spread to most areas with malaria. Alternative drugs to chloroquine are either associated with adverse reactions, are of limited efficacy, or require complex and detailed instructions for use that reduce compliance. These factors have contributed to a threefold increase in the number of reported P. falciparum infections among U.S. travelers to malarious areas since 1980. A new drug, mefloquine (Lariam), is expected to be highly effective against both chloroquine-resistant and Fansidar-resistant P. falciparum infections. Mefloquine is now recommended as the drug of choice for travelers at risk of infection with chloroquine-resistant P. falciparum. Alternative drugs for travelers who cannot take mefloquine include 1) doxycycline alone or 2) chloroquine alone, with Fansidar available for standby treatment while medical care is sought for evaluation of febrile illness when travelers are in a malarious area. Prospective travelers and health-care providers are advised to call the CDC Malaria Hotline at (404) 332-4555 for detailed recommendations for the prevention of malaria.
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PMID:Recommendations for the prevention of malaria among travelers. 215 46

Recommendations for the prevention of malaria among travelers have been developed by CDC in consultation with representatives from the Offices of Medical Services of the Department of State and the Peace Corps; the Division of Experimental Therapeutics of the Walter Reed Army Institute of Research; the Office of the Surgeon General, U.S. Army; the Office of the Surgeon General, U.S. Air Force; and the Bureau of Medicine and Surgery, U.S. Navy. Resistance of Plasmodium falciparum to chloroquine has spread to most areas with malaria. Alternative drugs to chloroquine are either associated with adverse reactions, are of limited efficacy, or require complex and detailed instructions for use that reduce compliance. These factors have contributed to a threefold increase in the number of reported P. falciparum infections among U.S. travelers to malarious areas since 1980. A new drug, mefloquine (Lariam), is expected to be highly effective against both chloroquine-resistant and Fansidar-resistant P. falciparum infections. Mefloquine is now recommended as the drug of choice for travelers at risk of infection with chloroquine-resistant P. falciparum. Alternative drugs for travelers who cannot take mefloquine include 1) doxycycline alone or 2) chloroquine alone, with Fansidar available for standby treatment while medical care is sought for evaluation of febrile illness when travelers are in a malarious area. Prospective travelers and health-care providers are advised to call the CDC Malaria Hotline at (404) 332-4555 for detailed recommendations for the prevention of malaria.
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PMID:From the Centers for Disease Control. Recommendations for the prevention of malaria among travelers. 215 78

The spread of chloroquine resistant strains of P. falciparum requires new approaches to treatment especially in tropical Africa. A single dose of 3 tablets of sulfadoxine-pyrimethamine (Fansidar) is a suitable and relatively inexpensive alternative. But under drug pressure resistance to this compound has developed in some South-East Asian countries and in Brazil, giving rise to multiple resistant strains of P. falciparum. A similar pattern has arisen with quinine to which almost 50% of P. falciparum strains have become resistant in Thailand. However the combination treatment of quinine with tetracycline given for 7 days is still successful in most cases. Unfortunately compliance to this regimen is rather poor in out-patients. Mefloquine (Lariam), recently marketed, and if used as 750 mg dose in semi-immune adult patients weighing less than 60 kg, has made possible a single-dose treatment schedule for falciparum malaria. In controlled studies conducted in South-East Asia the success rate of mefloquine was 97% in 445 patients. Since there is some fear of the appearance of resistance of P. falciparum to mefloquine, a combination of this compound with sulfadoxine and pyrimethamine was developed (MSP or Fansimef). Various controlled studies in South-East Asia have shown a success rate of this compound of 97% in 278 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The treatment of multiresistant falciparum malaria in Southeast Asia]. 266 11

Some 200 cases of malaria are officially reported yearly in Switzerland. It is estimated that 2000-8000 Swiss travellers are infected by the anopheles mosquito annually, with 90% protected by chemoprophylaxis. An attack of malaria appears to have a better prognosis when the symptoms start in Africa, since treatment is initiated immediately, than in industrialized countries where the mortality is 1-4%. Failure to inquire into travel history is often responsible for the delay in initiating treatment. Severe falciparum malaria is treated by repeated slow quinine infusions followed by 1500 mg sulfadoxine, 75 mg pyrimethamine and 750 mg mefloquine (single dose). This adult dose corresponds to 3 tablets of Lariam and 3 of Fansidar (or 3 of Fansimef). The increase in chloroquine resistance among falciparum strains has led to the use of Fansidar for chemoprophylaxis, followed by the use of mefloquine when Fansidar resistance occurs. The dosage of mefloquine is 250 mg weekly (1 tablet Lariam) for 4 weeks, followed by 1 tablet every fortnight. Treatment is continued for 1 month after return. If the risk of transmission is low, chemoprophylaxis may be replaced by prescription of a reserve drug to be taken in case of fever and headache. A sulfadoxine-pyrimethamine-mefloquine combination (i.e. 3 tablets Fansimef) has been tested in this indication. Ineffective chemoprophylaxis may lead to atypical clinical syndromes, e.g. anemia, hepatosplenomegaly and jaundice, without episodes of fever. HIV positive subjects may risk travelling in tropical countries if they have undergone correct chemoprophylaxis.
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PMID:[Malaria in Switzerland]. 306 91

A 42-year-old man was admitted to hospital with, previously wrongly diagnosed, fulminant falciparum malaria, 14 days after a two-week trip to Kenya. He had a high fever and was jaundiced, with severe anaemia and thrombocytopenia. He was given quinine intravenously and pyrimethamine/sulfadoxine (Fansidar) by mouth. He developed acute renal failure and increasingly severe cerebral symptoms, at times coma. An exchange transfusion and several plasmaphereses were, therefore, performed. The cerebral symptoms quickly abated during the exchange transfusion, but renal function failed to improve. Because of continuing fever, mefloquin (Lariam) and doxy-cycline (Vibramycin) were also administered. After several dialysis periods the patient improved gradually and was discharged after three weeks in generally good condition with normal renal function.
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PMID:[Exchange transfusion and (or) plasmapheresis: effective measures in severe tropical malaria?]. 328 61

In different countries opinions differ as to which chemotherapeutic methods should be used for malaria prophylaxis. It has long been the opinion of the Nordic countries, that WHO should give an official recommendation and the result is reflected now in the publication "Vaccination certificate requirements and health advice for internation travel." The malaria-endemic regions of the world are divided into 3 categories: regions without risk and no need for prophylaxis, low risk regions (A) with predominantly vivax inflections, risk regions (B) with predominantly chloroquine sensitive P. falciparum, and high risk regions (C) with often both chloroquine as well as sulfa/pyrimethamine resistance. Chloroquine is a sufficient prophylaxis for A-regions. For B-regions proguanil should be added and for C-regions only mefloquine is given. Proguanil was reintroduced basically because of Swedish research results in Liberia. An American initiative recommends for all regions, A-C, chemorprophylaxis as an alternative. However, a precondition is an observant traveller and clear instructions for self-treatment. Travellers who fall ill in a B-region should choose between Fansidar, mefloquine and quinine for self-treatment. Mefloquine has the least serious side effects, whereas quinine is therapeutically more safe. Fansidar very seldom gives any side effects. For C-regions only mefloquine is recommended for self-treatment. Nordic colleagues have recommended to double prophylaxis (chloroquine + Paludrine) treatment for the entire African tropical region. For short-time travellers to Kenya, Tanzania and Uganda, 6 tablets Lariam should be added. Only chloroquine is recommended for India and the Amazon region of South America. No chemoprophylaxis can guarantee full protection. Insect protection is therefore more important than ever. Malaria decreases the unspecific immune defense system. Surprisingly, repeated tests have shown that the AIDS frequency is not higher in patients with chronic malaria than for persons without plasmodia in the blood. In WHO's new little yellow booklet, a page concerning prophylaxis against AIDS appears. Equipment that is not new should be steamed or cooked for a least 20 minutes or treated with chemical disinfectants for at least 30 minutes. These measures should be enough to prevent HIV-infection.
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PMID:[Malaria and HIV prevention in WHO's "little gem"]. 338 44

Two studies were conduct in Thailand in order to find appropriate falciparum malaria prophylactic drug regimens. The first study was done during June - September 1987 with 363 soldiers who received Fansimef (MSP) 1 tab/week (group 1), 337 soldiers who received MSP 1 tab/2 week (group 2) and 165 soldiers who received chloroquine 300 mg base weekly plus Fansidar 1 tab/week (group 3). At the end of the study there were 9 and 13 falciparum malaria episodes in groups 1 and 2, respectively, with incidence rates of 0.8 and 1.8 cases/100 person-months (P-M). In group 3, the corresponding values were 30 episodes and an incidence of 7.2/100 P-M. For the second study which lasted from October 1987 - January 1988 in the same area, 498 soldiers were given Fansimef 1/2 tab/week (group 4), 499 soldiers were given Lariam 1/2 tab/week (group 5) and 247 soldiers were given chloroquine plus Fansidar (group 6). Thirty malaria episodes were found in group 4, for an incidence of 2.0/100 P-M. In group 5, 23 episodes were found, for an incidence of 1.6/100 P-M. In group 6, 74 episodes occurred, ie an incidence of 12.2/100 P-M. The incidence rates of malaria among Fansimef 1 tab weekly, Fansimef half dose weekly or Lariam half dose weekly were not significantly different but were different from chloroquine plus Fansidar groups. Adverse events in each group were mild.
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PMID:Prevention of Plasmodium falciparum malaria by Fansimef and Lariam in the northeastern part of Thailand. 793 38


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